George W L, Rolfe R D, Finegold S M
J Clin Microbiol. 1982 Jun;15(6):1049-53. doi: 10.1128/jcm.15.6.1049-1053.1982.
Fecal specimens from 223 subjects were evaluated for the presence of Clostridium difficile by use of a selective medium developed in our laboratory and for the presence of C. difficile cytotoxin. C. difficile and cytotoxin were detected in 89 and 83%, respectively, of patients with antimicrobial agent-associated pseudomembranous colitis (PMC). In patients in whom PMC was not documented, C. difficile and cytotoxin were present in only 37 and 21%, respectively. C. difficile and cytotoxin were also recovered from the feces of 6 and 3, respectively, of 13 antimicrobial recipients who did not have diarrhea. Although C. difficile appears to be a major cause of PMC, it is not responsible for at least some two-thirds of cases of antimicrobial agent-associated diarrhea in which PMC is not documented. Neither the recovery of C. difficile nor the detection of its cytotoxin should be considered diagnostic for C. difficile-induced disease.
采用我们实验室研制的一种选择性培养基,对223名受试者的粪便标本进行艰难梭菌检测,并检测艰难梭菌细胞毒素。在患有抗菌药物相关性假膜性结肠炎(PMC)的患者中,分别有89%和83%检测到艰难梭菌和细胞毒素。在未记录有PMC的患者中,艰难梭菌和细胞毒素的检出率分别仅为37%和21%。在13名未出现腹泻的抗菌药物接受者中,分别有6人和3人的粪便中也检出了艰难梭菌和细胞毒素。虽然艰难梭菌似乎是PMC的主要病因,但在至少三分之二未记录有PMC的抗菌药物相关性腹泻病例中,它并不是病因。艰难梭菌的检出及其细胞毒素的检测均不应被视为艰难梭菌所致疾病的诊断依据。